MEDICARE: MISS NEREIDA PADILLA CMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1417248774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NEREIDA PADILLA CMT

Provider Business Mailing Address
First Line	:	11177 TAMPA AVE
Second Line	:	STE A
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2254
Country	:	US
Telephone Number	:	818-831-8000
Fax Number	:	818-831-8005

Provider Business Practice Location Address
First Line	:	11177 TAMPA AVE
Second Line	:	STE A
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2254
Country	:	US
Telephone Number	:	818-831-8000
Fax Number	:	818-831-8005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	04/21/2011

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